Why was lamotrigine chosen for Ms. J? What other drug options exist to treat sleep epilepsy?
The authors’ observations
Many clinicians consider carbamazepine the drug of choice for NFLE. Because NFLE is an epilepsy of partial onset, however, medications used to treat partial-onset epilepsy—including lamotrigine, topiramate, oxcarbazepine, gabapentin, and levetiracetam—are presumed to work as well. Because lamotrigine is considered the safest antiepileptic in pregnancy, the neurologist chose this agent for Ms. J.
Although comparative studies of antiepileptics for partial epilepsies have shown no difference in efficacy,12,13 no comparative studies of antiepileptics in NFLE have been published.
Related resources
- Hales RE, Yudofsky SC (eds). Textbook of neuropsychiatry (3rd ed). Washington, DC: American PsychiatricPublishing,1997. Specific chapters:
- Adams JM, Berkovic SF, Scheffer IE. Autosomal dominant nocturnal frontal lobe epilepsy. Gene Reviews. Available at: http://www.geneclinics.org/profiles/adnfle/. Accessed Dec. 22, 2003.
Drug brand names
- Carbamazepine • Tegretol
- Gabapentin • Neurontin
- Lamotrigine • Lamictal
- Levetiracetam • Keppra
- Oxcarbazepine • Trileptal
- Topiramate • Topamax
Disclosure
The authors report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.